title: Guillain-Barré syndrome and Crohn disease: a case report.
abstract: Development of both Crohn disease and Guillain-Barré syndrome likely involves autoimmunity associated with excessive inflammatory cytokines. We treated a girl who developed Guillain-Barré syndrome during the course of Crohn disease. Although high-dose γ-globulin therapy administered initially for Guillain-Barré syndrome was ineffective, plasmapheresis ameliorated her acute neuropathic symptoms. Crohn disease was managed with Salazopyrin administration and enteral feeding. Chronic inflammation of the intestinal mucosa caused by Crohn disease can allow presentation of microbial intestinal antigens normally hidden from the immune system. Such presentation could incite an extraintestinal immune response on the basis of molecular mimicry, leading to activation of systemic autoimmunity against the nervous system. Accordingly, concurrence of Guillain-Barré syndrome and Crohn disease in our patient appeared to result from shared autoimmune mechanisms and systemic and local increases in cytokine concentrations. The patient also developed erythema nodosum and gall stones, relatively common complications of Crohn disease. However, Guillain-Barré syndrome is rare.
authors.affiliation: Department of Pediatrics, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Yanagida
authors.affiliation: Department of Pediatrics, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sugimoto
authors.affiliation: Department of Pediatrics, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: Akane
authors.initials: A
authors.lastname: Izu
authors.affiliation: Department of Pediatrics, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Wada
authors.affiliation: Department of Pediatrics, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Sakata
authors.affiliation: Department of Pediatrics, Kinki University Faculty of Medicine, Osaka-Sayama, Japan tsukasa@med.kindai.ac.jp.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Takemura
mesh_terms: D002648:Child; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D018450:Disease Progression; D005260:Female; D020275:Guillain-Barre Syndrome / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D006801:Humans
keywords: Crohn disease; Guillain-Barré syndrome; extraintestinal complication